The assisted living facility in Edina, Minnesota, where Jean Peters and her siblings moved their mother in 2011, looked lovely. 鈥淏ut then you start uncovering things,鈥 Peters said.
Her mother, Jackie Hourigan, widowed and developing memory problems at 82, too often was still in bed when her children came to see her midmorning.
鈥淪he wasn鈥檛 being toileted, so her pants would be soaked,鈥 said Peters, 69, a retired nurse-practitioner in Bloomington, Minnesota. 鈥淭hey didn鈥檛 give her water. They didn鈥檛 get her up for meals.鈥 Her mother dwindled to 94 pounds.
Most ominously, Peters said, 鈥渨e noticed bruises on her arm that we couldn鈥檛 account for.鈥 Complaints to administrators 鈥 in person, by phone, and by email 鈥 brought 鈥渢ons of excuses.鈥
So Peters bought an inexpensive camera at Best Buy. She and her sisters installed it atop the refrigerator in her mother鈥檚 apartment, worrying that the facility might evict her if the staff noticed it.
Monitoring from an app on their phones, the family saw Hourigan going hours without being changed. They saw and heard an aide loudly berating her and handling her roughly as she helped her dress.
They watched as another aide awakened her for breakfast and left the room even though Hourigan was unable to open the heavy apartment door and go to the dining room. 鈥淚t was traumatic to learn that we were right,鈥 Peters said.
After filing a police report and a lawsuit, and after her mother鈥檚 2014 death, Peters in 2016 helped found , which lobbied for a state law permitting cameras in residents鈥 rooms in nursing homes and assisted living facilities. Minnesota in 2019.
Though they remain a contentious subject, cameras in care facilities are gaining ground. By 2020, eight states had joined Minnesota in enacting laws allowing them, : Illinois, Kansas, Louisiana, Missouri, New Mexico, Oklahoma, Texas, and Washington.
The legislative pace has picked up since, with nine more states enacting laws: Connecticut, North Dakota, South Dakota, Nevada, Ohio, Rhode Island, Utah, Virginia, and Wyoming. Legislation is pending in several others.
California and Maryland have adopted guidelines, not laws. The state governments in New Jersey and Wisconsin will lend cameras to families concerned about loved ones鈥 safety.
But bills have also gone down to defeat, most recently in Arizona. For the second year, passed the House of Representatives overwhelmingly but, in March, failed to get a floor vote in the state Senate.
鈥淢y temperature is a little high right now,鈥 said state Rep. Quang Nguyen, a Republican who is the bill鈥檚 primary sponsor and plans to reintroduce it. He blamed opposition from industry groups, which in Arizona included LeadingAge, which represents nonprofit aging services providers, for the bill鈥檚 failure to pass.
The American Health Care Association, whose members are mostly for-profit long-term care providers, doesn鈥檛 take a national position on cameras. But its local affiliate also opposed the bill.
鈥淭hese people voting no should be called out in public and told, 鈥榊ou don鈥檛 care about the elderly population,鈥欌 Nguyen said.
A few camera laws cover only nursing homes, but the majority include assisted living facilities. Most mandate that the resident (and roommates, if any) provide written consent. Some call for signs alerting staffers and visitors that their interactions may be recorded.
The laws often prohibit tampering with cameras or retaliating against residents who use them, and include 鈥渟ome talk about who has access to the footage and whether it can be used in litigation,鈥 added Lori Smetanka, executive director of the National Consumer Voice.
It鈥檚 unclear how seriously facilities take these laws. Several relatives interviewed for this article reported that administrators told them cameras weren鈥檛 permitted, then never mentioned the issue again. Cameras placed in the room remained.
Why the legislative surge? During the covid-19 pandemic, families were locked out of facilities for months, Smetanka pointed out. 鈥淧eople want eyes on their loved ones.鈥
Changes in technology probably also contributed, as Americans became more familiar and comfortable with video chatting and virtual assistants. Cameras have become nearly ubiquitous 鈥 in public spaces, in workplaces, in police cars and on officers鈥 uniforms, in people鈥檚 pockets.
Initially, the push for cameras reflected fears about loved ones鈥 safety. Kari Shaw鈥檚 family, for instance, had already been who stole her mother鈥檚 prescribed pain medications.
So when Shaw, who lives in San Diego, and her sisters moved their mother into assisted living in Maple Grove, Minnesota, they immediately installed a motion-activated camera in her apartment.
Their mother, 91, has severe physical disabilities and uses a wheelchair. 鈥淲hy wait for something to happen?鈥 Shaw said.
In particular, 鈥減eople with dementia are at high risk,鈥 added Eilon Caspi, a gerontologist and researcher of elder mistreatment. 鈥淎nd they may not be capable of reporting incidents or recalling details.鈥
More recently, however, families are using cameras simply to stay in touch.
Anne Swardson, who lives in Virginia and in France, uses an Echo Show, an Alexa-enabled device by Amazon, for video visits with her mother, 96, in memory care in Fort Collins, Colorado. 鈥淪he鈥檚 incapable of touching any buttons, but this screen just comes on,鈥 Swardson said.
Art Siegel and his brothers were struggling to talk to their mother, who, at 101, is in assisted living in Florida; her portable phone frequently died because she forgot to charge it. 鈥淚t was worrying,鈥 said Siegel, who lives in San Francisco and had to call the facility and ask the staff to check on her.
Now, with an old-fashioned phone installed next to her favorite chair and a camera trained on the chair, they know when she鈥檚 available to talk.
As continues, a central question remains unanswered: Do they bolster the quality of care? 鈥淭here鈥檚 zero research cited to back up these bills,鈥 said Clara Berridge, a gerontologist at the University of Washington who聽
鈥淒o cameras actually deter abuse and neglect? Does it cause a facility to change its policies or improve?鈥
Both camera opponents and supporters cite concerns about residents鈥 privacy and dignity in a setting where they are being helped to wash, dress, and use the bathroom.
鈥淐onsider, too, the importance of ensuring privacy during visits related to spiritual, legal, financial, or other personal issues,鈥 Lisa Sanders, a spokesperson for LeadingAge, said in a statement.
Though cameras can be turned off, it鈥檚 probably impractical to expect residents or a stretched-thin staff to do so.
Moreover, surveillance can treat those staff members as 鈥渟uspects who have to be deterred from bad behavior,鈥 Berridge said. She has seen facilities installing cameras in all residents鈥 rooms: 鈥淓veryone is living under surveillance. Is that what we want for our elders and our future selves?鈥
Ultimately, experts said, even when cameras detect problems, they can鈥檛 substitute for improved care that would prevent them 鈥 an effort that will require engagement from families, better staffing, training and monitoring by facilities, and more active federal and state oversight.
鈥淚 think of cameras as a symptom, not a solution,鈥 Berridge said. 鈥淚t鈥檚 a band-aid that can distract from the harder problem of how we provide quality long-term care.鈥
The New Old Age is produced through a partnership with .
